Posts filed under ‘Special Rants’
Transgender men and women often find themselves stymied halfway through transition. Historically, hormone therapy and swapped out wardrobes marked the end of physical change, the goal being to look good enough to face society and hold down a job. The new frontier, however, is gaining access to bona fide gender reassignment and life in a much larger world. It doesn’t have to feel like the search for the Holy Grail…a little help, please.
Being the strong person in a marginalized community carries a heavy weight. Admirers gather because they think you’ve got it made, and they want to learn how to get there themselves. They come with a bottomless pit of need; if only they could feel like you do. They lose sight of the fact that you have the same fears they have, that you hate your body, and that you believe you were somehow marked for pain with no relief in sight. This is definitely not as good as it gets…but even your allies are pulling you down and keeping you from clarifying that vision of your future that will make it all worthwhile.
Many people crater emotionally after achieving milestones in their lives. Depression, if a recurring theme, is exhausting. The search for life and enduring love is at best sweet and sour. And success often gets redefined by the next challenge before one can fully enjoy an emerging victory. For a person going through gender transition, that trifecta is completed by an official diagnosis of gender dystopia. Hurray…you are officially in the wrong body. Now what?
Gender reassignment remains controversial, mostly due to ignorance. Would-be supporters fear the costs, forgetting that all the data available is exaggerated by the burden of a long history of predatory pricing. Conscientious objectors often overlook that they defined deities and wrote the books on right and wrong as mere mortals who had not yet discovered the limbic system in the brain. Political fanatics decry the day that their government will force its citizens “to pay for sex changes for confused illegal aliens…” while they send their kids off to denial camps. Get a grip, guys. Someone’s life got too complicated a while ago; we can help sort it out if we get out of our own way. The path to accessible and affordable gender reassignment is not so complex. It simply depends on…
- Acceptance of transgender status and the appropriateness of medical and surgical intervention for gender reassignment;
- Protocols for gender transition with combined physical and psychosocial supports;
- Coverage in health insurance plans
- Establishing maximum allowable charges for procedures and other therapies,
- Making contributions toward coverage with reasonable copayments or coinsurance, and
- Screening providers for quality assurance and maintaining networks of caregivers for enrollees in need of transgender services; and
- Ensuring safety nets for those unable to pay for health insurance.
Broader access to care does not have to be financially catastrophic to individuals or 3rd party sponsors of healthcare financing. Inclusion of transgender procedures in insurance contracts would quickly eliminate much of the predatory pricing that characterizes the field. In addition, while there may be significant pent-up demand for transgender services, this would be a temporary phenomenon. In fact, employers who offer transgender coverage often report lower than expected initial demand.
Finally, appropriate healthcare for a transgender person cannot depend on personal wealth or employment. These two factors are inextricably linked and, often, neither is available in the midst of gender transition. Many transgender people have a very difficult time securing employment, and initial hormone therapy and cosmetic procedures rapidly exhaust personal savings. The surgical process may interfere with the patient’s ability to sustain employment due to complex, iterative procedures and the dearth of work places that offer true safe harbors for trans employees. In the meantime, the process of personal grooming each day, negotiating safe passage from home to the workplace, and achieving acceptance by their peers remains a devastating burden. No, this cannot be as good as it gets.
Note: This is the third in the series of Special Rants under the heading of Transgender Trilogy, a very personal cause that became unavoidably compelling after the recent death of my stepdaughter whose life as a transgender woman overwhelmed her. Posts #1 The Search for Life After Gender Transition & #2 A Useless Lament
“How can you say I don’t love you…when I’m already crazy with grief over losing you?
When children “come out” to their parents, those parents must quickly make a choice. Will they look into their hearts and see the child they have nurtured since birth standing before them asking for validation of who they really are? Or will they become lost and overwhelmed by their own needs, focusing on their lost visions of who that child was supposed to be. In time, I hope most would do the right thing. The problem is how to sustain that son or daughter’s life while taking his or her primary support system through its own recovery loop.
My husband loved his transgender daughter. Unconditional acceptance of her had always been implicit in his parenthood. At her memorial service at the LGBT Center in the West Village, some of her friends from the local community approached him to ask him to do “Dad training.” Later a request came to “write a letter to my mother.” We were among survivors in a world in which staying alive had barely better than 50:50 odds. Who might be next?
The cause of death was suicide, not a random accident or a rare disease that attacks the young. We were all devastated, and we sought one another out for comfort. As the stories of seemingly bizarre parental behavior were shared, Jonathan suppressed, for the moment, his urge to shout, “What’s wrong with these people? For Chrissakes, their kids are still alive!
Of course people would be persuaded to be more accepting of their children if they realized their lives depended on it, right? We wished that we had known the risk of suicide was so high. With our “if only” list still growing, we thought about educating others as a way of coping. But obvious answers often draw counter-intuitive responses.
How can you mediate a truce and eventual acceptance between a child who is coping with his or her most difficult transition in life and a parent who can only ask, “Why is this happening to ME?” Did we even want to know such parents? Every day somebody’s child was going to give himself or herself the death penalty for failure to be accepted by society. Couldn’t they at least get validation at home?
The trouble is, for at least some of the parents, even the threat of suicide seems blunted by the loss they are already grieving. The son or daughter they had born was gone, along with the prepackaged collection of predictable events and experiences that come with gender role stereotypes. And their insecurities may have them panicking that, in lieu of sympathy, their friends and associates might reject them. They are so focused in their own introspection as to become clueless. Given the perilousness of the situation, you could call it temporary insanity.
A person going through gender transition carries too heavy a load to be asked to carry their families, too. But is it right to ask people struggling in uncharted waters to keep going without the well-known lifeline of their parents? Emotionally, no…but as a practical matter, the added baggage of one’s family may need to be set aside. Hopefully, it is a timing thing. Eventually, many parents will be able to reconnect with the core identity of their child in a transfigured body. But such parents must find their own sources of support. And they must know what a risk they could be taking in looking the other way while their kid – grown up or not – is going it alone.
We have met a lot of very kind yet sharp-witted overachievers in the transgender community. They are the courageous few who have believed in themselves enough to take on the world. However, their parents can still take them down in a thoughtless phone call. Never mind the threats of disinheritance or eternal damnation. They need our support and more general public acceptance because their families are not likely to be there for them when it counts. And if they are…it still might not be enough.
For now, the sad state of the art renders expectations quite low. We were incredulous when met with a tragic expression of gratitude. “Thank you for letting us grieve with you,” a privilege previously denied by next-of-kin, perhaps from another planet. No wonder crises of confidence are so prevalent in the trans community. We must do better than this.
Note: This is the second post in the series of Special Rants under the heading of Transgender Trilogy, a very personal cause that became unavoidably compelling after the recent death of my stepdaughter whose life as a transgender woman overwhelmed her. Post #1 The Search for Life After Gender Transition & #3 This is NOT as Good as It Gets
Our political system has become dysfunctional over the issue of access to healthcare for the people of the United States. Protectors of capitalism claim that the Affordable Care Act will undermine business. The keepers of our democracy claim that those without the money to pay the high price of healthcare have spoken, and the nation has heeded their call. The real problem is that capitalism has failed to fund a real winner in recent memory.
Healthcare inflation has been fueling our economic growth to far too long. It has accounted for expansion of private business, growth in employment, and favorable stock performance. The industry has been a rare goose that laid golden eggs. Unfortunately, it has been one that has crowded out investment in other factors of production, consuming an ever-growing percentage of our nation’s GDP. And the result has been an over-reliance on healthcare investments that paradoxically leave too many citizens of the US unable to afford to get well. The ACA seeks a cure for the latter, but Wall Street is totally freaked about losing the former.
The false dichotomy has become one of choosing between sick people and capitalism. But the real culprit is our new generation of pseudo-capitalists running the markets. We do not have a market economy that is funded by shareholders taking long positions. After three decades of supply-side economics the result has been a net divestment of the supply function. Out-of-control healthcare costs and real estate shenanigans have been the darlings for investors. Oh yeah, and serial monogamy in pursuit of each paradigm shift in tech stocks.
Today’s growth opportunities for investors on the margin are driven by boom-bust cycles in fool’s gold. Buy stocks or other financial instruments while they’re hot, sell at the right time before they crash and burn. We’ve been here before…in the 80s, a heyday of stock market gains based on insider trading. Today’s formulas are more complicated, the code among thieves more discreet, but the watchdogs must smell smoke by now. Healthcare stocks that celebrate $78,000 cures for ovarian cancer for the rich, on the other hand, seem virtuous by comparison. At least the assets are real.
The ACA is a done deal: legislated in Congress, signed by the President, and validated by the Supreme Court. But where is the strategic vision for real economic development in the US?
Privatization strategies for government services suggest greater efficiency through good economic decision making. However, there is no valid end game for shareholders. If the enterprise can make money, then profits can be gained in the short run. However, diffusion of better practices should mean cost reductions across the industry and containment of government spending in areas such as education. The only way shareholders have long-term gains is through maintenance of runaway government spending or choosing profits over service delivery to the children.
Privatization strategies for government services are as perennial as down cycles in economics. When perplexed by a gloomy economic outlook, pseudo-capitalists turn to short-term profit-skimming strategies. And Wall Street doesn’t mind. They get transaction fees on the way up and on the way back down. Such is the case with privatization of education services, and regulation accounting only makes it easier. Real gold and fool’s gold look the same if you only keep the books to track grant money.
Every government service would benefit from accounting practices that allowed sound economic analyses and prudent choices. Not-for-profit entities often shun good business practices, and they are not required by funders. The existence of charitable motives supersedes the need for efficient management practices. Besides, changing time-honored regulatory procedures is a lot of bother. School districts summarize their spending in five giant accounts, and school accountants worry a lot about ensuring nobody pilfers the money from the vending machines. How the hundreds of billions of dollars for “general instruction” gets divided up is unimportant. Why wouldn’t a few scoundrels jump in?
The problem is…if profiteers are able to create real shareholder value, they must be generating earnings growth into perpetuity. And this is not a good idea for education or for our economy. If the profiteers are running the business of education better and turn a profit, then the rest of the industry should be able to try their techniques, if valid, and use them to trim overall government spending. The profits should go away. If the profits don’t go away, they are either arising from wasteful government spending or from choosing to give money to shareholders instead of the kids.
The US economy does not need a new way for investments in government services that crowd out investments in real economic growth. Nor do we need for profiteers to be short-changing children in a Spartan industry that thrives on short-term economic gains. Further, we do not need another Wall Street darling that rises and falls with a net negative impact to the US economy of fees taken by the traders.
What we need in education is help from private industry in the form of management insight that teaches us how to be more effective and efficient managers of carefully contained education spending. And that does not have to mean union busting or parental surcharges. It means keeping the books in a more meaningful way. It means managing people in a better way. And it means assimilation of modern opportunities into an historically rigid structure. And it has to mean that a dollar saved…means another dollar that could be added to what we do for the kids in a better way.
And Wall Street needs to get back to finding real investment strategies in our long-run economic growth and real shareholder value creation.
I met Donna at First Night 1996 in Boston…but I did not really get to see her until a couple of summers ago. She, called David at the time, had told her father and mother that she was coming to town and wanted to have dinner with each of them. An announcement was expected…she tiptoed forward in conversation. After dinner she said she was going upstairs to change her clothes to go out for the rest of the evening with friends. I was anxious as she came back downstairs…the woman who greeted me was relaxed and happy. She was herself at last.
We buried Donna on Tuesday. She was a wonderful woman who seemed to be a model for gender transition. She was in a relationship with a wonderful person. She was actively writing – her forte – and doing readings and even a little stand-up comedy. She had made a big move in a successful professional career. She had many, many good friends. She touched countless lives in times of need…as the giver. Yet the despair in her inner life prevailed.
Gender transition is characterized by extreme courage and fragility. For many, it is the beginning of peace within one’s body, taking charge and becoming oneself. But the cost is great. The time it takes to get into the new role each day is daunting but essential. Society is a harsh critic with every misstep. Permanent physical changes are painful and expensive. Most people must pay out-of-pocket for medical and cosmetic procedures that are subject to predatory pricing, use experimental techniques, and are inadequately monitored for quality.
Throughout the transition, and often beyond, many choose to cope within the safe harbor of mutual experience, marginalized in a supportive trans community. They occupy the lowest totem in the LGBT community – often asked to lay low and abstain from political action that might compromise a winning campaign…like the crazy aunt who it welcomed to the table at private family gatherings but whom everyone is afraid to invite to the wedding.
But the search for equity in the face of gender and sexuality issues should not be a burden carried solely within any subgroup of Americans. Trans rights are human rights, guaranteed in our promise of freedom for life, liberty, and the pursuit of happiness. They are not special privileges handed out by loving parents and special counselors at school or under a rainbow flag on Pride Day.
Remembering Donna in the past tense will always be painful. But the celebration of her life belongs in the mainstream…helping those struggling to survive in a life that is not just valid but well worth living.
Note: This is the first post in the series of Special Rants under the heading of Transgender Trilogy, a very personal cause that became unavoidably compelling after the recent death of my stepdaughter whose life as a transgender woman overwhelmed her. Post #2 A Useless Lament & #3 This is NOT as Good as It Gets
What could be better for conservatives than creating non-government jobs that drive up government spending through private mismanagement that you can blame on progressives until you can dream up your next flax-spinning scheme? Um…how about investing our nation’s savings in factors of real economic development? No…alchemy makes better campaign rhetoric, and it’s all about getting re-elected in the midterms.
I took a couple of weeks off Twitter only to return the same old…with a new spin. Deregulation of private charters – when the numbers don’t look good; getting rid of the tests – when educators get caught cheating on them; and direct funding of students – only if they go to private schools. This future vision plays right into the hands of an opportunistic and amoral conservative political bloc.
Privatization of government services has emerged again as the perennial antidote to deficit spending. Whenever our nation’s economy seems hopelessly mired in the trough of a business cycle, conservative politicians seem to turn a blind eye to economic development, their alleged forte. They choose, instead, to look for opportunities to appear to create private-sector jobs by churning pre-existing government jobs into their own.
The key to privatization is that it sounds like it might be a good idea. First, you demonize union workers. Then you cite the evils of government spending. Finally, you turn to technological innovation as the new magic pill. Who better to turn this situation around than an entrepreneur from the private sector?
The flaw in the plan? It calls for investing private money that only sustains profit growth through excessive government spending. There is no real end game for investors. It is a short-term fix for the appearance of economic growth. And it has a real economic opportunity cost. If our “job creators” can’t do any better than this, things might just be worse than we thought…and that’s no April Fool.
This should be a no-brainer. The $500 billion dollar elementary and secondary education market needs to be fiscally responsible. And our economy needs to expand through investment in real productive assets. Yet private investors are seeking to skim profits off of the poorly administered public education money instead of going for new economic capacity. They misinterpret the difference between a stimulus package steeped in short-term spending on employment and infrastructure improvements in education and long-term profit-planning through economic growth.
Private firms eyeing profits from U.S. public schools: “…Now investors are signaling optimism that a golden moment has arrived. They’re pouring private equity and venture capital into scores of companies that aim to profit by taking over broad swaths of public education.”
This excerpt from a Reuters press release yesterday tells us that US “job creators” still don’t get it. They continue to do profit planning based on eating our young. Building a renewed private sector based on extending government spending on PreK-12 education will not make this nation stronger economically. Nor will it make sense to crowd out other investments in productive assets by developing a shadow industry for private investment money in alternative education services.
In the recent past election, the US economy was a key issue. It remains so. However, we continue to see private investment in the very public goods that conservative politicians sought to curb. Cutting healthcare spending and privatizing education were targeted as solutions, but we still need to see evidence that our great economic visionaries can see past their next short sale. The private growth opportunities cannot be healthcare and education. They crowd-out investments for the future.
Healthcare spending already consumes as much of GDP as should ever be reasonable in a stable economy. The $1 trillion investment in college loans to kids is already too high. New private dollars going into public education will continue to dampen the job opportunities for the children once they finish high school and college.
Yes, the brick-and-mortar infrastructure in education is crumbling and needs to be reinforced. And, yes, the children in the classroom should be protected from the feast and famine of economic cycles. However, compensatory money spent in either area must be seen as short-term spending.
In addition, existing private companies that serve this industry need to follow the market from paper to digital media. They must do this to survive – not expand. New players may emerge because they do this better, but the overall industry should not grow faster than the economy in the long run.
$500 billion may be enough to fund public education. We are not sure, but we need to find out what we are buying with our money. However, as long as our financial data system in education lacks transparency, the looters will come.
Comments below were posted on the Washington Post site to correct the record for Deval Patrick and support the validity of his comments in his speech at the Demoncratic National Convention. The erroneous fact-checking as reported by the Washington Post can be found here. The Washington Post had suggested that Governor Patrick’s claim that he had to pick up the pieces after Governor Romney left crumbling roads and bridges across Massachusetts was debatable because the evidence was subjective?!?
TRUE on Romney’s crumbling bridges and roads in Massachusetts…
During his first year in office, after the Minneapolis bridge collapse in August 2007, Deval Patrick ordered that all bridges in Massachusetts be assessed for safety, and hundreds were found to be in serious need of repair or replacement. Patrick has delivered on a large number of bridge repair/replacement recommendations so far in his administration, and the work continues. On the roads…The Big Dig consumed the vast majority of funds for road repair projects through the many Republican administrations in Massachusetts from 1990-2006. Highways and surface arteries were is severe disrepair. Patrick has restored the roads to far better condition.
In response to a reader comment suggesting that road work was just a timing thing…
The Big Dig was not completely over…the project had been poorly managed, taking years more than planned and cost overruns resulted in about twice the original budget. A daunting punchlist remained with no money, fatalities from falling ceiling tiles, flooding, and use of dry concrete in bridge work. Patrick was the first governor to try to hold contractors accountable.
In response to the same reader suggesting that Martha Coakley was responsible for a settlement…
Martha Coakley and Deval Patrick serve together. Ms Coakley does the legal work as Attorney General. In cases where a contractor screwed up, that firm was given the 1st option of setting things right. Then the suits were filed, if necessary.
There has never been a more important Democratic National Convention. As educators, we cannot get hung up on resolving our pet issues this week. Rather, we must support the election of the political leaders we consider most ready to serve us for the next four years. If we are looking for a presidential candidate who will continue to serve all Americans, we must rally around President Obama under a big tent.
Is Barrack Obama your best choice for President as a US citizen and an educator? If so, it is time to set aside your personal agenda and rally around the President in unity. Is it odd that Chelsea Clinton will be interviewing Michelle Rhee, both life-long Democrats? Yes. Will it be awkward to cheer Democratic Party leaders while sitting next to antagonists in the debates over pedagogy, teacher contracts, or accountability? Sure. Do you have unresolved issues with the short list of policy imperatives in the party platform? Of course…No national exigency can be adequately addressed in a campaign designed for voters with short attention spans and infinite needs.
The DNC is not the place for policy debate. It is not about the tactical issues that divide us this week…unions, charters, assessments, evaluations, pedagogy, teachers, parents, funding, etc. We all have our political positions and our pivotal issues, but broad-based solutions for public education can only be negotiated on common ground. That starts with electing leaders who will be most likely to serve all Americans for the next four years.
Here’s hoping for a week that ends with a sustainable big convention pop for the President…not another dreary game of Pop Goes the Weasel in the carnival of education debate. Seriously, the real weasels could win, and that would be a lose-lose for all of us.
In response to Michael Petilli’s post of 8/20/2012 in which he misleads the public on the Ryan healthcare plan…
Rep. Ryan has proposed a budget that raises healthcare spending while reducing benefits to the poor and the elderly. Obama has added benefits and reduced payments to providers, creating a net improvement in the healthcare trust fund, which Ryan’s plan further depletes. I have addressed healthcare spending and the remedy with the aging of the population more fully in my blog as a topic of relevance to retired educators, and I concur with the President’s approach through the ACA. Read more here…http://schoolsretooled.com/2011/10/17/health-economics-rant/